Alhamdulillah, I survived my first week of clinic and third year! It was exhausting and interesting, and really quite unlike what I expected. It feels strange that after spending two years in the classroom and learning about various subjects related to medicine, to suddenly be thrust into an examining room with a patient. You are expected to be able to automatically switch from student mode into the physician role, complete with thinking of differential diagnoses as soon as the patient describes their chief complaint. It’s not easy. Especially if your first rotation is tough and has many patients being seen by several clinicians.
My rotation this month is at the Wound Care center at the clinic in our school. Its one of those rotations that has a reputation for being tough and extremely busy, especially while still studying for the boards. My first day was memorable to say the least. My fellow group members and I arrived before 8 AM and attended a short orientation that consisted of learning where some of the vast amount of supplies are located. As soon as it was 8:30, the clinicians instructed us to “grab a chart and let’s get going!”. We all held the patients’ charts in our hands and really didn’t know what to do for a few minutes; all the knowledge of those practice sessions with standardized patients flew out of the window and all what was left was anxiety. Were we really to be trusted-I mean expected- to examine a real patient with infected ulcers? Debride hyperkeratotic lesions on a diabetic patient? Examine a patient with MRSA alone? We really were not expecting to hit the ground running, but as we found out soon, there’s no time to waste in wound care!
Eventually, we were able to gather our wits and examine our patients. After a few halting starts and several mistakes, we were able to gain some sort of system. Those of us currently without a patient cleaned and prepped rooms, while the others tried to finish their charts in order to help their group members later. We had to learn the ropes while climbing, especially as there was only one fourth year available in our module who was not very helpful. Yes, we did get scolded by the attendings and we did get lost while searching for a dressing or topical cream, but we managed to make it work.
As most of us, myself included, had an injection workshop in between clinic on that first day, we left the clinic, attending the lecture, returned to the clinic as soon as the lecture was over, then left the clinic again to attend the lab, before finally returning to the clinic at the end of the day to finish our charts. We were finally finished at 4 PM. Straight, without a single break. Its’s 12 PM already? But you still have a incomplete chart, and there are five more people waiting to be seen. Welcome to the real world, where your patient takes priority over everything.
It was a crazy, adrenaline running high, oh my God I don’t know what I’m doing kind of day, but alhamdulillah it was over. Every day since then, we have been exposed to a myriad of wounds and procedures, so that each day is a new experience for us. In just five days, I’ve seen some cases that I have only read about in books, and others that I would have never imagined. I’ve learned to question why Dr. A does a procedure this way, and why Dr. B won’t do it that way. I’ve learned to stop by the supply desk early to grab a pair of bandage scissors to keep in my pocket for those “just in case” moments. I’ve picked up on the fact that when your attending says to come at a certain time, to arrive 15 minutes earlier. I’ve mastered the task of running after the clinician so he can sign the chart before he disappears to another module for half an hour. I’ve discovered that by asking your patient their history while performing their physical exam can save you a whole lot of valuable time. And I’ve realized that no matter how much I thought I knew, I have barely scratched the surface. Although I will probably be called out on yet another mistake tomorrow morning, I’ll take it in stride and enjoy the experience while trying to learn the most I can this month inshaAllah.